Effectiveness of Pain and Exercise Training With Telerehabilitation on Lumbar Facet Joint Arthrosis

NCT04981132 | Completed

• 1 other identifier: 0366
• Study Type: interventional
• Target: 45
• Locations: 1 country
• Sites: 1

Brief Summary

The study investigates the effects of pain and exercise training via telerehabilitation method on pain, pain beliefs, trunk mobility, functionality, and quality of life in individuals with low back pain caused by facet joint arthrosis. Forty - five individuals are planning to include in the study. Participants will be randomly assigned to one of the three groups: Group 1: Pain education + exercise training group, Group 2: Exercise training group, and Group 3: Control group. The same physiotherapist will make evaluations via an online conference system. Group 1 will have pain neuroscience education and progressive therapeutic exercise training in a session for six weeks, twice a week, and Group 2 will have progressive therapeutic exercise training in a session for six weeks, twice a week, for six weeks, in total twelve sessions. Group 3 participants will be taken to the waiting list. Clinical and demographic data of the 45 participants in the study will be taken pre and post interventions. The primary outcomes are; the Numeric Pain Rating Scale (NPRS) and the Oswestry Disability Index (ODI). Secondary outcomes are the Active Straight Leg Raise Test (A- SLR), The Pain Belief Questionnaire (PBQ), and the Short Form Quality of Life Form (SF-12). Statistical analysis will be run through the SPSS 20.0 package program.

Conditions

Facet Joint Arthrosis; Low Back Pain

Keywords

facet joint arthrosis; low back pain; exercise; education; telerehabilitation

Outcome Measures

Primary Outcomes (4)

• The Numerical Rating Scale

  It is a frequently used scale with proven validity and reliability (Clark 2003, Boonstra 2008), consists of a horizontal line 100 mm long. There are two marks at the beginning and end of the line. The mark at the beginning of the line indicates 0 mm - no pain; the mark at the end of the line - 100 mm - unbearable pain. Subjects will be asked to place a mark on this horizontal line for the maximum pain they feel during rest and activity, and the results will be recorded in cm.

  Pre - intervention

• The Numerical Rating Scale

  It is a frequently used scale with proven validity and reliability (Clark 2003, Boonstra 2008), consists of a horizontal line 100 mm long. There are two marks at the beginning and end of the line. The mark at the beginning of the line indicates 0 mm - no pain; the mark at the end of the line - 100 mm - unbearable pain. Subjects will be asked to place a mark on this horizontal line for the maximum pain they feel during rest and activity, and the results will be recorded in cm.

  6 weeks later (Post intervention)

• The Oswestry Disability Index

  The Oswestry Disability Index(ODI) is an extremely important tool that researchers and disability evaluators use to measure a patient's permanent functional disability. The test is considered the 'gold standard' of low back functional outcome tools. Scores between 0-5 are given for each question on the scale consisting of 10 questions. Questions are on travel, social life, sex life, sleeping, standing, sitting, walking, lifting things and personal precautions. Maximum score is 50, minimum score is 0.

  Pre - intervention

• The Oswestry Disability Index

  The Oswestry Disability Index(ODI) is an extremely important tool that researchers and disability evaluators use to measure a patient's permanent functional disability. The test is considered the 'gold standard' of low back functional outcome tools. Scores between 0-5 are given for each question on the scale consisting of 10 questions. Questions are on travel, social life, sex life, sleeping, standing, sitting, walking, lifting things and personal precautions. Maximum score is 50, minimum score is 0.

  6 weeks later (Post intervention)

Secondary Outcomes (6)

• Active Straight Leg Raise Test

  Pre - intervention

• Active Straight Leg Raise Test

  6 weeks later (Post intervention)

• The Short Form 12

  Pre - intervention

• The Short Form 12

  6 weeks later (Post intervention)

• The Pain Beliefs Questionnaire

  Pre - intervention

Study Arms (3)

Education+Exercise Group

EXPERIMENTAL

Group 1: Patients will have 15 minutes of pain neuroscience education (PNE) and 30 minutes of progressive therapeutic exercise training (PTE) with the telerehabilitation method.

Behavioral: Pain Neuroscience education + Progressive therapeutic exercise training

Exercise group

EXPERIMENTAL

Group 2: Patients will have 45 minutes of progressive therapeutic exercise training (PTE) with the telerehabilitation method.

Behavioral: Progressive therapeutic exercise training

Control Group

NO INTERVENTION

Group 3: Participants will be taken for the waiting list after evaluation with the telerehabilitation method.

Interventions

Pain Neuroscience education + Progressive therapeutic exercise training BEHAVIORAL

The education group will have a comprehensive patient education which includes; description, transmission, representation of pain, central sensitization, neuroplasticity, its relation to body systems, psychosocial and emotional factors affecting pain, pain behavior, and lifestyle changes to cope with pain, etc. Plus, the group will have supervised progressive therapeutic exercises via the telerehabilitation method.

Education+Exercise Group

Progressive therapeutic exercise training BEHAVIORAL

The exercise group will have supervised progressive therapeutic exercises via the telerehabilitation method.

Exercise group

Eligibility Criteria

• Age: 40 Years - 64 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• volunteering,
• being the ages of 40 to 64
• having a diagnosis of Grade 1 or 2 facet joint arthrosis according to Pathria classification
• having pain for at least 12 weeks, primarily due to facet joint arthrosis
• having a pain score between 3 and 8 according to the Numerical Pain Scale (NRS)
• not having received education about pain before,
• having computer and internet access

You may not qualify if:

• having a BMI of 30 and above
• to have had conservative treatment or surgery in the lumbar region in the last 6 months,
• having severe deformity in the lower extremity
• having red or orange (pregnancy, disc pathology, infection, fracture, cancer, stenosis, severe osteoporosis, schmorl nodule, cauda equina syndrome, etc.) signs defined for low back pain
• having a regular exercise habit,
• having a seronegative rheumatological disease,
• having general pain syndrome.

Sponsors & Collaborators

• Okan University: lead
• Istanbul University - Cerrahpasa: collaborator

Study Sites (1)

Istanbul University - Cerrahpaşa

Istanbul, Turkey (Türkiye)

Location

Related Publications (13)

• Clarke CL, Ryan CG, Martin DJ. Pain neurophysiology education for the management of individuals with chronic low back pain: systematic review and meta-analysis. Man Ther. 2011 Dec;16(6):544-9. doi: 10.1016/j.math.2011.05.003. Epub 2011 Jun 25.

  PMID: 21705261 BACKGROUND

• Cottrell MA, Galea OA, O'Leary SP, Hill AJ, Russell TG. Real-time telerehabilitation for the treatment of musculoskeletal conditions is effective and comparable to standard practice: a systematic review and meta-analysis. Clin Rehabil. 2017 May;31(5):625-638. doi: 10.1177/0269215516645148. Epub 2016 May 2.

  PMID: 27141087 BACKGROUND

• Fatoye F, Gebrye T, Fatoye C, Mbada CE, Olaoye MI, Odole AC, Dada O. The Clinical and Cost-Effectiveness of Telerehabilitation for People With Nonspecific Chronic Low Back Pain: Randomized Controlled Trial. JMIR Mhealth Uhealth. 2020 Jun 24;8(6):e15375. doi: 10.2196/15375.

  PMID: 32357128 BACKGROUND

• Louw A, Diener I, Butler DS, Puentedura EJ. The effect of neuroscience education on pain, disability, anxiety, and stress in chronic musculoskeletal pain. Arch Phys Med Rehabil. 2011 Dec;92(12):2041-56. doi: 10.1016/j.apmr.2011.07.198.

  PMID: 22133255 BACKGROUND

• Louw A, Zimney K, Puentedura EJ, Diener I. The efficacy of pain neuroscience education on musculoskeletal pain: A systematic review of the literature. Physiother Theory Pract. 2016 Jul;32(5):332-55. doi: 10.1080/09593985.2016.1194646. Epub 2016 Jun 28.

  PMID: 27351541 BACKGROUND

• Moseley L. Combined physiotherapy and education is efficacious for chronic low back pain. Aust J Physiother. 2002;48(4):297-302. doi: 10.1016/s0004-9514(14)60169-0.

  PMID: 12443524 BACKGROUND

• Palacin-Marin F, Esteban-Moreno B, Olea N, Herrera-Viedma E, Arroyo-Morales M. Agreement between telerehabilitation and face-to-face clinical outcome assessments for low back pain in primary care. Spine (Phila Pa 1976). 2013 May 15;38(11):947-52. doi: 10.1097/BRS.0b013e318281a36c.

  PMID: 23238489 BACKGROUND

• Bodes Pardo G, Lluch Girbes E, Roussel NA, Gallego Izquierdo T, Jimenez Penick V, Pecos Martin D. Pain Neurophysiology Education and Therapeutic Exercise for Patients With Chronic Low Back Pain: A Single-Blind Randomized Controlled Trial. Arch Phys Med Rehabil. 2018 Feb;99(2):338-347. doi: 10.1016/j.apmr.2017.10.016. Epub 2017 Nov 11.

  PMID: 29138049 BACKGROUND

• Saracoglu I, Arik MI, Afsar E, Gokpinar HH. The effectiveness of pain neuroscience education combined with manual therapy and home exercise for chronic low back pain: A single-blind randomized controlled trial. Physiother Theory Pract. 2022 Jul;38(7):868-878. doi: 10.1080/09593985.2020.1809046. Epub 2020 Aug 19.

  PMID: 32812478 BACKGROUND

• Truter P, Russell T, Fary R. The validity of physical therapy assessment of low back pain via telerehabilitation in a clinical setting. Telemed J E Health. 2014 Feb;20(2):161-7. doi: 10.1089/tmj.2013.0088. Epub 2013 Nov 27.

  PMID: 24283249 BACKGROUND

• Turolla A, Rossettini G, Viceconti A, Palese A, Geri T. Musculoskeletal Physical Therapy During the COVID-19 Pandemic: Is Telerehabilitation the Answer? Phys Ther. 2020 Aug 12;100(8):1260-1264. doi: 10.1093/ptj/pzaa093. No abstract available.

  PMID: 32386218 BACKGROUND

• Wood L, Hendrick PA. A systematic review and meta-analysis of pain neuroscience education for chronic low back pain: Short-and long-term outcomes of pain and disability. Eur J Pain. 2019 Feb;23(2):234-249. doi: 10.1002/ejp.1314. Epub 2018 Oct 14.

  PMID: 30178503 BACKGROUND

• Tahran O, Ersoz Huseyinsinoglu B, Yolcu G, Karadag Saygi E, Yeldan I. Comparing face-to-face and internet-based basic body awareness therapy for fibromyalgia: a randomized controlled trial. Disabil Rehabil. 2025 Sep;47(19):4987-4998. doi: 10.1080/09638288.2025.2465597. Epub 2025 Feb 19.

  PMID: 39970076 DERIVED

Related Links

• Application
• WCPT

MeSH Terms

Conditions

Low Back Pain; Motor Activity

Condition Hierarchy (Ancestors)

Back Pain; Pain; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Behavior

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: MSc. Pt

Study Record Dates

• First Submitted: June 21, 2021
• First Posted: July 28, 2021
• Study Start: October 15, 2021
• Primary Completion: May 15, 2022
• Study Completion: May 15, 2022
• Last Updated: August 24, 2023

Record last verified: 2023-08

Locations

TU (1)